One Health: Need for Collaborative Efforts

Sujit M. Kolangath,Suresh H. Basagoudanavar and Madhusudan Hosamani
Indian Veterinary Research Institute,
Hebbal,
Bangalore(India) - 560024

• Introduction
• History of 'One Health'
• Significance of 'One health'
• Challenges to 'One health' and requisite remedies
• Summary
• References

Introduction

Human and animals have been co-existing from time immemorial. With the advancement in science, we are discovering diseases that are common to man and animals. This group of diseases termed 'zoonotic' could be transmitted to human beings from either domesticated or wild animals. As a result of increasing encroachment of the forests and reserves meant for the wild, newer diseases are emerging which were once restricted to animal population. It is reported that about 60% of known infectious diseases of the humans have their origin in the animals [1]. Zoonotic diseases like highly pathogenic avian Influenza have adverse effects on human health, apart from heavy economic losses due to bird mortality [2]. Therefore, it is essential for a timely effort to control these zoonotic diseases. This needs collaborative involvement of medical as well as veterinary professionals. Because the infectious disease reservoirs are so varied, it requires the guardians of both human and animal health to collaborate in the areas of theoretical knowledge, technical know how, vaccine development, diagnostics, disease surveillance and monitoring, epidemiology and pathogenesis. The challenge to restrict the cross species transmission of an infection is a difficult task and as such, controlling the disease in a single species itself cannot be adequate. Therefore, this necessitates an interdisciplinary collaborative effort to ensure that the zoonotic diseases are controlled at the reservoir, amplifier or at final host stage to block its transmission to humans [3,4]. It is important to realize that 'One Health' is not limited to the diseases of man and animal but requires a wider approach to have a safer and cleaner ecosystem. Considering the fact that the infectious diseases are transmitted by unsafe water and food [5], there is a desired need to emphasize the control of diseases that are transmitted to humans via the water and food. To protect the human health, it is mandatory that the food of the animal origin should be strictly inspected for the pathogens and only safe food should be marketed. This necessitates responsible involvement of field veterinarians and food inspectors, respectively at the stage of food production and processing plants [6]. Similarly, the physicians have the responsibility of spreading awareness among the masses in order to control the outbreaks of food and water borne infections and also by treating the clinical cases.

The emerging concept of one health is an approach to ensure health to man, animals and environment [7]. Being part of the ecosystem where in humans, livestock, pet animals and wildlife are dependent on each other, an integrated approach to human and animal health is crucial. Therefore, it requires the cohesive efforts from veterinarians, physicians and other arms of the public health, to ensure health to man and also to ensure nutritional food security.

History of 'One Health':

The importance of collaboration between medical as well as veterinary professionals was proposed in 19th century by Rudolf Virchow (1821-1902). He stressed the need to unify the study of the diseases of man and animal. He felt that a disease results from interaction of host, environment and pathogen, and as such the diseases of humans and animals can hardly be ever demarcated [8]. Later, Calvin Schwabe coined the term 'One Medicine' and advocated the need for collaborative efforts between human and animal medicine for ensuring the control of the zoonotic diseases and eradication where possible [9,10]. Taking a clue from this, in 2004, wildlife conservation society concept of one health was broadened to 'one world, one health' with the idea of encompassing the health of animals and humans in the context of the ecosystem that supports life at large. In 2008, the FAO, OIE, WHO and UNICEF, together with the World Bank and the UN System In?uenza Coordinator [UNSIC] emphasized on greater interdisciplinary and collaborative efforts for ensuring the global health and for the eradication of the zoonotic diseases.

Significance of 'One Health':

An outbreak of zoonotic infections causes loss of physical well being and is also an economical burden to the society. One health ensures health to all components of the ecosystem including man [11]. Remembering the fact that food borne outbreaks of diseases are common in our society, by encouraging healthy animals and healthy environment, we can reduce the number of disease outbreaks [12]. Consequently, a healthy society can channelize its resources for the economic growth and development, by limiting the transmission of diseases and thus preventing economical burden associated with infectious diseases.

The world population is growing at an uncontrolled rate. With this, food security is becoming a challenge. Given to understanding that land resources are limited we have to depend at least partly, on food of animal origin [13]. Healthy animals are a source of wholesome food like meat, milk, fish and eggs. Outbreak of infectious diseases among food animals would lead to loss of production. Therefore, it is necessary to ensure that the animals are healthy and capable of producing high quality food. In this context, 'One health' advocates healthy animals, and thus safe food. Apart from advocating clean rearing of animals, it emphasises the need for vaccination and deworming, to have healthy animals with sustained production.

Among professionals involved in agriculture, health care, research, animal husbandry and processing of animal based products, occupational zoonoses are a concern [14]. Considering that it is a serious threat to the health of the society if occupational zoonoses are not controlled, 'One health' endorses efforts to rear healthy animals and safeguard their health.

Companion animals have been part of our society since time immemorial. They add a sense of well being. However they could be source of many transmittable diseases to human beings. It is important that these animals are regularly dewormed and vaccinated. One health also aims to safeguard the health of the companion animals.

'One health' also aims to control trans boundary animal diseases that could cause substantial economic damage to agrarian community. In this regard, OIE has recommended international collaboration that intends for an integrated effort of multiple disciplines to achieve favourable health for humans, animals and the environment. Further, but the preparedness of the public health services to tackle emerging diseases is very essential. Therefore, the interaction between veterinarians and physicians can bring about collaborative control strategies to deal with any such outbreak in the future. Also intense monitoring and disease surveillance in their respective arena of expertise can provide vast information regarding the emergence of new pathogens and thus an alarm system for the prediction of the emerging disease can be designed [15].

Further, threats of bioterrorism could be tackled if the physicians, veterinarians and researchers in both the fields collaborate and draw strategies to control any such disease outbreaks and will strengthen preparedness to tackle any such outbreak.

Challenges to 'One Health' and requisite remedies:

Though the concept of 'one health' originated in 19th century, no practical outcome has yet been achieved. Due to intermittent exchange of knowledge and experience between physicians and veterinarians, the human and animal diseases have been mostly treated as separate entities. Each discipline tries to tackle the problem only in its domain of expertise. Since zoonotic diseases cross beyond the species boundaries, it is necessary to make joint efforts for ensuring protection of human and animal health [16]. There is a need to bring in a harmonious culmination of human and animal health professions, to develop a common platform where the experts from both the professions can interact.

Current academic programmes provide least emphasis on comparative medicine. There is a dearth of trained professionals equipped with knowledge of human, animal and environment. Professionals with knowledge of medicine and environment are needed to work with public health and civic authorities to curtail zoonotic diseases. Therefore, there is a need of compulsory courses of comparative medicine at undergraduate and post graduate levels so that trained man power can be resourceful for the accomplishment of health for all [17]. There is international need to orient veterinarians, physicians, environmentalists on the benefits of 'one health'.

Most emerging infectious diseases have origin in socio-economically poor countries that have dense human settlement and intense human-animal interaction [18]. This correlates with lack of good infrastructure for health care and public hygiene.

Resistance of pathogens to antimicrobial agents is a huge concern in therapeutics of human infections. Presence of traces of the antibiotics in food derived from animals could be one of the reasons for this situation. This necessitates the responsibility sharing by both veterinarians and physicians to protect the animal and human health through judicious use of therapeutics [19].

Currently, efforts to achieve community health involving humans and animals are focussed at regional levels. However, it should be realized that due to uncontrolled movement of humans and animals across borders, there is a need for an international collaboration, involving government as well as non-government organisations (NGOs), to assist the professionals and experts to bring one health into reality. As this activity would involve high investment, financial constraints could be felt. To overcome this, the government of states as well as World Bank should initiate funding effort. NGOs could carry out the efforts to outreaching the needy.

Summary:

Though one health and its significance to human well being have been recognised at various levels, a lot needs to be done practically, both at national as well as international levels to make it a reality. There is an obvious need for intense collaborative efforts from the professionals of the medical, veterinary, public health, wild life and policy makers to achieve rewarding results. The collaborative efforts will surely solve many mysteries of epidemiology, pathogenesis and other health related concerns. Further, efforts under the umbrella of 'one health' would make the dream of 'health to all' a reality.

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